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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215928
Report Date: 06/17/2020
Date Signed: 06/17/2020 04:56:36 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:GARCIA FCC AKA ABIGAIL'S DAY CAREFACILITY NUMBER:
426215928
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 3DATE:
06/17/2020
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Deysi Cordova GarciaTIME COMPLETED:
04:51 PM
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On June 17, 2020, at 1:30 PM, Licensing Program Analyst (LPA) Martina Jimenez conducted an announced Tele- Inspection for the purpose of performing a pre-licensing inspection. Due to the COVID - 19 and California Department of Public Health guidelines of social distancing, a tele-inspection was conducted. LPA Jimenez conducted the tele-inspection via FaceTime and met with Deysi Cordova Garcia, Applicant and discussed the purpose of the Inspection. Applicant was caring for her 2 of applicant's own children and one niece at the time of the tele-inspection.

Applicant applied for a Small Family Child Care license. Family members residing in the home are three adults. Per Applicant, her operating hours will be Monday through Friday from 6:00 a.m. to 6:00 p.m. Applicant states she wants to care for children from birth to 12 years of age.

LPA Jimenez with the assistance of the applicant conducted a virtual tour of the interior and exterior of the home. The home is three bedrooms, two bath single story home with an attached garage. All adults in the home are fingerprint cleared. LPA observed the off-limits areas which include the 3 bedrooms 1 bathrooms, kitchen, and garage secured with doorknob covers and safety gates. The fireplace which is located in the living room has glass doors and will not be used. The bathroom used by children was observed to be clean and free of toxins. LPA observed clean, safe, age appropriate toys. LPA observed the home to be orderly. All hazardous items are stored inaccessible to children in care.

LPA observed backyard outdoor play area with age appropriate toys, play structure, cactus, roses, spotting soil, shovel, ladders, wheel barrel, paint, lighter fluid, two storage sheds. There was one storage shed was observed to be unsecured, which contained tools, and gardening items. Backyard is adequately fenced. There are no bodies of water observed. No bodies of water were observed on site. LPA observed detergents and cleaning compounds stored out of reach of children. Medication and sharps in the home are stored on elevated shelves in the kitchen's cabinets. The carbon monoxide and smoke alarm detector affixed to the hallway which was tested at 2:04 PM and found to be operable. LPA reminded the Applicant Family Child Care Homes (FCCH) must maintain operable carbon monoxide and smoke alarm detector at all times. LPA observed a fire extinguisher on site which was purchased on 2/16/20. Applicant is reminded to service or purchase the fire extinguisher yearly.

CONTINUED ON 809-C
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: GARCIA FCC AKA ABIGAIL'S DAY CARE
FACILITY NUMBER: 426215928
VISIT DATE: 06/17/2020
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The applicant completed Preventative Health training on 02/27/20. Applicant’s Pediatric CPR and First Aid certificate expires on 10/08/2021. Applicant informed LPA no firearm or ammunition is stored on site. Applicant does not have a foster care license. LPA reviewed Mortgage Statement to verify control of property. Applicant states the FCCH does not currently have liability insurance. LPA informed applicant that parents will need to sign a waiver for the liability insurance if insurance is not obtained (applicant was provided form- LIC 282). The Applicant has not completed AB 1207 Mandated Reporter training, due to AB 1207 is currently not available in Spanish.

Applicant is not providing Incidental Medical Services. Incidental Medical Services (IMS) policy was discussed. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA issued the applicant updated samples of state required forms to be kept in the children's records via Email. LPA discussed with applicant a packet of updated samples of state required forms to be kept in the children's file, required forms to be posted and forms that needs to be maintained at the FCCH. LPA also discussed and provided information about “The effects of Lead,” “Sudden Infant Death Syndrome/Safe sleep,” and “Capacity requirements.”

Applicant was reminded that it is her responsibility to know the regulations for Family Child Care Home which can be accessed on-line at www.ccld.ca.gov. Also, applicant was reminded that baby walkers, jumpers, bouncers, exersaucers, or any similar article are not permitted on the premises during day care hours.



Based on the LPA’s observation, the following corrections need to be corrected prior to obtaining a Small Family Child Care license. Corrections are due by 07/01/2020.

1. Applicant must sign and return a copy of this pre-licensing report.
2. Applicant must make the following items inaccessible to day-care children; cactus, roses, spotting soil, shovel, ladders, wheel barrel, paint, lighter fluid, storage shed, which contained tools, and gardening items in the backyard play area.
3. Applicant must place padding under swing set and slide
4. Applicant will send photos to LPA Jimenez of the corrections.

Exit interview was conducted with Deysi Cordova Garcia, via tele-inspection, during which appeal rights were explained. This report along with a copy of the appeal rights will be sent to the Applicant via email with a read receipt or confirmation of receipt of email, which will act as the Applicants signature.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.

SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2020
LIC809 (FAS) - (06/04)
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